1. Simulation-Based Training for Nurses in Sterile Techniques During Central Vein Catheterization
- Author
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Hassan Khouli, Adnan Aqeel, Louis N. Gerolemou, Amelita Fidellaga, James Jones, Qifa Han, Janet M. Shapiro, Keith Rose, Majella Venturanza, and Scott E. Cooper
- Subjects
Catheterization, Central Venous ,medicine.medical_specialty ,Inservice Training ,Manikins ,Critical Care Nursing ,Asepsis ,law.invention ,symbols.namesake ,Patient safety ,law ,Critical care nursing ,Humans ,Medicine ,Computer Simulation ,Poisson Distribution ,Prospective Studies ,Poisson regression ,Prospective cohort study ,Intensive care medicine ,business.industry ,Incidence ,Incidence (epidemiology) ,Sterilization ,General Medicine ,Intensive care unit ,Catheter-Related Infections ,Emergency medicine ,symbols ,Observational study ,Patient Safety ,business ,Program Evaluation - Abstract
BACKGROUND The effectiveness of simulation-based training of critical care nurses in sterile techniques has not been determined. OBJECTIVE To evaluate the effectiveness of simulation-based training of critical care nurses to use sterile techniques during central vein catheterization and the effect of such training on infection rates. METHODS A prospective controlled study with 12-month observational follow-up to assess the rate of catheter-related bloodstream infections in a 23-bed medical, surgical, neurological critical care unit. RESULTS Forty-six critical care nurses completed assessment and training in sterile technique skills in the simulation laboratory. Performance scores at baseline were poor: median scores in each category ranging from 0 to 2 out of a maximum score of 4 and a median total score of 7 out of a maximum score of 24. After simulation-based training, nurses' median scores in each ST category and their total scores improved significantly, with the median total score increasing to 23 (P < .01; median difference, 15; 95% CI, 14-16). After completion of the simulation-based training intervention, the mean infection rate in the unit was reduced by 85% from 2.61 to 0.4 infections per 1000 catheter-days (P = .02). The incidence rate-ratio derived from the Poisson regression (0.15; 95% CI, 0.03-0.78) indicates an 85% reduction in the incidence of catheter-related bloodstream infections in the unit after the intervention. CONCLUSION Simulation-based training of critical care nurses in sterile technique is an important component in the strategy to reduce the occurrence of such infections and promote patient safety.
- Published
- 2014